TY - JOUR
T1 - Post-chemoradiation intraoperative electron-beam radiation therapy boost in resected locally advanced rectal cancer
T2 - Long-term results focused on topographic pattern of locoregional relapse
AU - Sole, Claudio V.
AU - Calvo, Felipe A.
AU - Serrano, Javier
AU - Del Valle, Emilio
AU - Rodriguez, Marcos
AU - Muñoz-Calero, Alberto
AU - Turégano, Fernando
AU - García-Sabrido, Jose Luis
AU - Garcia-Alfonso, Pilar
AU - Peligros, Isabel
AU - Rivera, Sofia
AU - Deutsch, Eric
AU - Alvarez, Emilio
N1 - Publisher Copyright:
© 2014 Elsevier Ireland Ltd. All rights reserved.
PY - 2014/7/1
Y1 - 2014/7/1
N2 - Background: Patients with locally advanced rectal cancer (LARC) have a dismal prognosis. We investigated outcomes and risk factors for locoregional recurrence (LRR) in patients treated with preoperative chemoradiotherapy (CRT), surgery and IOERT. Methods: A total of 335 patients with LARC [≥cT3 93% and/or cN+ 69%) were studied. In multivariate analyses, risk factors for LRR, IFLR and OFLR were assessed. Results: Median follow-up was 72.6 months (range, 4-205). In multivariate analysis distal margin distance ≤10 mm [HR 2.46, p = 0.03], R1 resection [HR 5.06, p = 0.02], tumor regression grade 1-2 [HR 2.63, p = 0.05] and tumor grade 3 [HR 7.79, p < 0.001] were associated with an increased risk of LRR. A risk model was generated to determine a prognostic index for individual patients with LARC. Conclusions: Overall results after multimodality treatment of LARC are promising. Classification of risk factors for LRR has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment.
AB - Background: Patients with locally advanced rectal cancer (LARC) have a dismal prognosis. We investigated outcomes and risk factors for locoregional recurrence (LRR) in patients treated with preoperative chemoradiotherapy (CRT), surgery and IOERT. Methods: A total of 335 patients with LARC [≥cT3 93% and/or cN+ 69%) were studied. In multivariate analyses, risk factors for LRR, IFLR and OFLR were assessed. Results: Median follow-up was 72.6 months (range, 4-205). In multivariate analysis distal margin distance ≤10 mm [HR 2.46, p = 0.03], R1 resection [HR 5.06, p = 0.02], tumor regression grade 1-2 [HR 2.63, p = 0.05] and tumor grade 3 [HR 7.79, p < 0.001] were associated with an increased risk of LRR. A risk model was generated to determine a prognostic index for individual patients with LARC. Conclusions: Overall results after multimodality treatment of LARC are promising. Classification of risk factors for LRR has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment.
KW - External beam radiation therapy
KW - Intraoperative radiotherapy
KW - Locally advanced rectal cancer
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84908210011&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2014.05.012
DO - 10.1016/j.radonc.2014.05.012
M3 - Article
C2 - 24997989
AN - SCOPUS:84908210011
SN - 0167-8140
VL - 112
SP - 52
EP - 58
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -